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Caregiver Burden

Gregg K. Takashima, DVM, WSAVA Global Nutrition Committee Series Editor

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In the Literature

Spitznagel MB, Jacobson DM, Cox MD, Carlson MD. Predicting caregiver burden in general veterinary clients: contribution of companion animal clinical signs and problem behaviors. Vet J. 2018;236:23-30.


A burden on caregivers has been observed in owners and human caregivers of pets with chronic or terminal illness and has been linked to multiple negative psychosocial outcomes (eg, stress, depression). Caregiver burden has also been linked to a need for more of a clinician’s nonbillable time, which contributes to the veterinary team’s busy and stressful workload.

This 2-phase study examined whether common clinical signs and problem behaviors in pets with chronic or terminal disease could predict caregiver burden and how understanding this might help clinicians better address and assist owners. Several patient signs and behaviors that correlate with caregiver burden were observed, particularly weakness; appearing sad, depressed, or anxious; apparent pain/discomfort; change in personality; frequent urination; and excessive sleeping or lethargy.

From the information gathered, a pet problem severity scale that could successfully predict caregiver burden was developed. This scale could be a useful tool for understanding problems that contribute to owner stress, which could aid clinicians in assessing what actions can be taken to give owners a better sense of control (eg, effective communication of treatment plans and potential outcomes). This, in addition to compassionate support, may facilitate better clinician–owner relationships, improve compliance, and decrease workload for the veterinary team.


Key pearls to put into practice:


Clinicians should be aware of the signs and behaviors that can contribute to caregiver burden.



Effectively communicating treatments and potential disease course can help provide owners with an improved sense of control.



A variety of options for owner support (eg, phone consultations, internet-based support groups) should be offered.


For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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